Provider Demographics
NPI:1083801583
Name:LEVENTIS, CHRIS
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:
Last Name:LEVENTIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3606 OCEAN RANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-2669
Mailing Address - Country:US
Mailing Address - Phone:760-231-8189
Mailing Address - Fax:
Practice Address - Street 1:3606 OCEAN RANCH BLVD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-2669
Practice Address - Country:US
Practice Address - Phone:760-231-8189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter